Provider Demographics
NPI:1295729978
Name:RICHMOND RADIOLOGISTS, INC.
Entity type:Organization
Organization Name:RICHMOND RADIOLOGISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BRENDLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-966-2929
Mailing Address - Street 1:35 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-5441
Mailing Address - Country:US
Mailing Address - Phone:765-966-2929
Mailing Address - Fax:765-966-2845
Practice Address - Street 1:35 S 8TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-5441
Practice Address - Country:US
Practice Address - Phone:765-966-2929
Practice Address - Fax:765-966-2845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-08
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50000783A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN50000783AOtherLICENSE NUMBER